Bleeds in the lower limbs
The ilio-psoas muscle is the hip flexor muscle.
For these bleeds, the only good form of immobilisation is bed rest with the hip as straight as possible. It may be necessary to use a pillow to support the leg in the very acute stage, but as soon as possible this must be removed. It is advisable to lie on the stomach (prone lying) for periods of the day – this is to stretch the hip muscles.
For these bleeds, the only good form of immobilisation is bed rest with the hip as straight as possible. It may be necessary to use a pillow to support the leg in the very acute stage, but as soon as possible this must be removed. It is advisable to lie on the stomach (prone lying) for periods of the day – this is to stretch the hip muscles.
After a hip bleed/psoas bleed it is advisable to also do quadriceps exercises.
1. Free hip extension
2. Stretching ilio-psoas muscle with assistance
3. Stretching ilio-psoas muscle
4. Hip flexion against gravity
5. Hip flexion against resistance (weights)
6. Free hip abduction (away from the centre)
7. Hip abduction against gravity
These are the muscles that straighten and bend the knee. The medial (inner) part of the quadriceps muscle helps to “lock” the knee when straightening it. This muscle needs to be strengthened as soon as possible to reduce the risk of re-bleeds when walking or running.
Quadriceps (Extention muscle)
Pull kneecap – a
Push knee down onto bed – b
Pull toes up – c
Quadriceps (Extention muscle)
1. Static contractions of quadriceps muscle (knee extension muscle)
Push knee down onto bed – b
Pull toes up – c
2. Knee extension against gravity with a small range of movement
3. Knee extension against gravity with a greater range of movement
4. Knee extension against resistance (weights) with a small range of movement
5. Knee extension against resistance (weights) with a greater range of movement
These are the muscles that straighten and bend the knee. This muscle needs to be strengthened as soon as possible to reduce the risk of re-bleeds when walking or running.
1. Free knee flexion
2. Knee flexion against gravity
3. Knee flexion against resistance (weights)
A bleed in the calf muscle would affect knee and ankle movement.
Position the ankle in mid-position, and the knee as straight as possible.
The same applies for an ankle bleed.
Ankle and Calf muscle
Balancing and Stretching exercises (Following a muscle bleed)
Position the ankle in mid-position, and the knee as straight as possible.
The same applies for an ankle bleed.
Ankle and Calf muscle
1. Free ankle plantarflexion (foot down) and dorsiflexion (foot up)
1. Weight bearing for ankles
2. Walking on toes or heels balancing exercise
3. Exercise on a ‘wobble board’ balancing exercise
4. Stretching of hamstring muscle
5. Weight bearing exercise for calf muscles
6. Stretching exercise for calf muscle
7. Stretching exercise for calf muscle #2